More to hospital expansion than meets the eye

Building a new hospital in New Lenox appears, on its face, a splendid proposal, especially if you live nearby.

But Illinois' history of hospital expansion and construction carries baggage. Imagine a 25-pound Samsonite stuffed with political insiders, kickbacks, bribery, campaign donations, political favoritism and good old-fashioned greed.

Toss in skepticism from state officials who are holding hospitals to higher standards over the amount of charity care they provide, and you've got hospitals struggling to satisfy a high bar if they want to grow.

Under that backdrop, Silver Cross Hospital's plan to build a new $400 million, 600,000-square-foot facility at Interstate 355 and U.S. 6 in New Lenox is seeing a deeper level of scrutiny. The project requires approval from the Illinois Health Facilities Planning Board, which gained statewide attention after one-time board member Stuart Levine was accused of squeezing construction firms for kickbacks. Under Levine's reign, hospitals that wanted to expand were pressured to pay certain "fees" in order to get approval, federal prosecutors allege in Levine's 2005 indictment.

Meanwhile, Attorney General Lisa Madigan has pressured Illinois hospitals to be more diligent in justifying their nonprofit status. Many Illinois hospitals pay no property taxes and receive a break on corporate income taxes. In exchange, they are expected to provide a commensurate level of charity care to the uninsured and the poor.

Trouble is, many nonprofit hospitals are spending far too little on charity care while receiving huge tax breaks from the state.

So Silver Cross, of Joliet, in its application to build a new facility, is being forced to address all these issues - and rightfully so.

By its critics, the hospital is accused of abandoning a poor, black neighborhood on Joliet's east side in favor of greener pastures and whiter, wealthier clients.

That, too, deserves exploration. Former Health Facilities Planning Board chairman Glenn Poshard criticized two proposals, one from Advocate and one from St. Francis of Blue Island, when they both wanted to build new hospitals along LaGrange Road.

"The last thing this board wants to do is penalize somebody because they live in an affluent community," Poshard said in denying the two proposals in 2006. "But in an area that is affluent that has hospitals on the periphery but doesn't have one right in the community doesn't mean those people are not being served."

He and the board at that time would not support a new hospital in the southwest suburbs because five or six others already exist within a 30-minute drive. Suburban residents should not be treated to a posh new facility simply because they don't want to drive to Joliet, Harvey or Blue Island.

Poshard said in some downstate communities, patients drive 50 or 60 miles for any type of acute care, and arguments about community boundaries would be scorned.

Poshard is not on the current planning board. Most of the members were reshuffled after the Levine fallout.

But the Silver Cross case still rests upon many of the same principles. By moving 3 miles east, is Silver Cross leaving the population that needs it the most?

"Silver Cross has an exemplary record of providing service to the medically undeserved and to all residents," said Ruth Colby, vice president of business development for Silver Cross. "We have been very involved in the east side of Joliet."

Silver Cross puts its charity care expenditure annually at $10.9 million. That number represents 5.9 percent of the hospital's net revenue, according to Colby. The hospital eats another $5.6 million in bad debt from people who simply don't pay their medical bills, she said.

Those numbers put Silver Cross ahead of the pack in terms of charity care compared to overall hospital revenues when contrasted with Cook County hospitals analyzed by the Center for Tax and Budget Accountability. The center did not analyze Will County facilities.

Silver Cross, Colby said, is committed to turning part of the Joliet campus into an urgent care center, if the hospital wins approval to build in New Lenox. A committee chaired by Will County Board member Margie Woods will oversee redevelopment of the Joliet site.

That sounds well and good. Perhaps Silver Cross will convince the Health Facilities Planning Board of its need to revamp and relocate. Maybe it's the right thing to do.

But there is much, much more to hospital relocation than what meets the eye. Chicago and suburban residents are spoiled with an array of choices. The board should think carefully about the precedent it might set in approving Silver Cross' proposal.

Kristen McQueary covers government and politics for the SouthtownStar. She can be reached at (708) 633-5972 or kmcqueary@southtownstar.com.